Orofacial Pain: Prevalence in Private General Practices of Northwest PRECEDENT

Methods: Data on the presence and type of orofacial pain during the previous year were abstracted from dental charts in a survey with a systematic random sample of adult patients (n=1272, 18-93 years old, 43% female) visiting Northwest PRECEDENT general dentists (n=75). Types of pain were classified as dentoalveolar (dental and periodontal abscesses, irreversible pulpitis, and other tooth-related pain in the previous year); musculoligamentous (arthralgia, myalgia or other symptoms of temporomandibular disorders); soft-tissue (aphthous ulcers, herpes and burning mouth syndrome); and neurological (headache and migraine). Prevalence ratios were estimated using multiple Poisson regression with robust standard error.

Results: Prevalences of types of orofacial pain in the past 12 months were 8.6% for dentoalveolar pain or pulpitis [95% Confidence interval (CI)=6.4%-10.8%], 5.9% for musculoligamentous pain (95%CI=3.6%-8.2%), 0.5% for soft tissue pain (95%CI=0.2%-0.9%), and 0.2% for neurological pain (95%CI=0.0%-0.5%). Females were 3 times as likely to have a record of musculoligamentous pain than males (95%CI=1.8-5.2). Age, race/ethnicity, malocclusion status, tooth wear and missing teeth were not significantly associated with prevalence of musculoligamentous pain. Class III malocclusion [Prevalence ratio (PR)=2.0, 95%CI=1.1-3.7], 4+ teeth with wear (PR=1.6, 95%CI=1.0-2.4) and 4+ missing teeth (PR=1.6, 95%CI=1.0-2.4) were associated with an increased prevalence of dentoalveolar pain.

Conclusion: Records of orofacial pain in the last 12 months were relatively uncommon in this patient population. Compared to specialist-based surveys, these dental records may have underestimated the orofacial pain prevalence in private dental practice settings. Pain related to the teeth and surrounding tissues and pain related to temporomandibular disorders were by far the most prevalent pain conditions. Submitted on behalf of Northwest PRECEDENT network, with support from NIDCR grants DE016750 and DE016752.